| Sonny Sullivan, PA-C | |
|
15855 19 Mile Rd, Clinton Twp, MI 48038-3504 | |
| (800) 532-2411 | |
| Not Available |
| Full Name | Sonny Sullivan |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 3 Years |
| Location | 15855 19 Mile Rd, Clinton Twp, Michigan |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215610779 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AS0400X | Physician Assistant - Surgical | 5601011968 (Michigan) | Secondary |
| 363A00000X | Physician Assistant | 5601011968 (Michigan) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Henry Ford Macomb Hospital Corporation | 7911808381 | 349 |
| Entity Name | Henry Ford Macomb Hospital Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134265986 PECOS PAC ID: 7911808381 Enrollment ID: O20040119000142 |
| Entity Name | Munson Healthcare Cadillac |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336539063 PECOS PAC ID: 6305161514 Enrollment ID: O20150401000808 |
| Mailing Address | Practice Location Address |
|---|---|
| Sonny Sullivan, PA-C 5838 S Mission Rd, Mt Pleasant, MI 48858-5531 Ph: (989) 854-2266 | Sonny Sullivan, PA-C 15855 19 Mile Rd, Clinton Twp, MI 48038-3504 Ph: (800) 532-2411 |
Ms. Leeann Wickens, P.A. Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 15855 19 Mile Rd, Clinton Twp, MI 48038 Phone: 586-203-1940 |
Diane Stephanie Kaczmarek, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 36367 Harper Ave, Clinton Twp, MI 48035 Phone: 586-791-6868 Fax: 586-791-5071 |
Tyler Wundrach, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 15855 19 Mile Rd, Clinton Twp, MI 48038 Phone: 586-263-2320 Fax: 586-203-1050 |
Holly Alderman, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 43740 Garfield Rd, Clinton Twp, MI 48038 Phone: 586-228-0270 Fax: 586-228-9019 |
Jamie Rae Hutchison, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 39836 Baroque Blvd, Clinton Twp, MI 48038 Phone: 501-606-0887 |
Nicole Vandamme, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 15855 19 Mile Rd Ste 3a, Clinton Twp, MI 48038 Phone: 586-236-2370 |
Katherine Elizabeth Wasek, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 16510 19 Mile Rd, Clinton Twp, MI 48038 Phone: 586-263-7200 |